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Re: Propensity score models

To: Ravi Varadhan <rvaradha@jhsph.edu>
Subject: Re: Propensity score models
From: Frank E Harrell Jr <fharrell@virginia.edu>
Date: Tue, 22 Apr 2003 14:11:49 -0400
Cc: flom@ndri.org, s-news@lists.biostat.wustl.edu
In-reply-to: <001701c308f9$7d4e53b0$1158120a@BSTE3005>
Organization: University of Virginia
References: <sea548a4.070@MAIL.NDRI.ORG> <001701c308f9$7d4e53b0$1158120a@BSTE3005>
On Tue, 22 Apr 2003 14:03:33 -0400
Ravi Varadhan <rvaradha@jhsph.edu> wrote:

> Dear Peter:
> 
> There is nothing special to program in propensity score models. You simply
> use existing logistic regression ("glm" with logit or some other links)
> software for a binary treatment variable, as a function of all covariates
> that may possibly affect the assignement. In other words, you model
> Pr(Z=1 | covariates), where Z=1 indicates treatment and Z=0 indicates
> placebo or some other treatment.
> 
> Ravi.

In addition to what Ravi said, in invaluable tool is lowess with the iter=0 
option (or use the plsmo function in the Hmisc library which uses this) if your 
outcome variable is binary.  Stratify by actual treatment received and get a 
nonparametric estimate relating propensity for treatment to probability of 
outcome using lowess.  This does not adjust for subject heterogenity (hence 
odds ratios are biased towards the null) as you do in the final model (which 
includes propensity and covariates) but it adjusts for confounding on a 
continuous basis.  In my experience this is better than adjusting just for 
quintiles of propensity.  If your outcome is continuous and ols is appropriate, 
you can use lowess or loess with default parameters to get this graph.  These 
graphs do not assume a functional form for propensity vs. outcome, only 
smoothness.

Continuous analyses are greatly preferred but to demonstrate the adjustment for 
confounding to non-statisticians, matched-sets analyses are educational, 
matching on propensity.  Some functions in Hmisc help with this.
---
Frank E Harrell Jr              Prof. of Biostatistics & Statistics
Div. of Biostatistics & Epidem. Dept. of Health Evaluation Sciences
U. Virginia School of Medicine  http://hesweb1.med.virginia.edu/biostat

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